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We've designed our cities, suburbs, food industry, and society such that the average person is at least overweight, nearing obese. If the average person suffer

We've designed our cities, suburbs, food industry, and society such that the average person is at least overweight, nearing obese. If the average person suffers from what should be an anomaly, perhaps it is less a personal failing than a societal failing and we should try to fix the societal problems generating the poor outcome.

JumpCrisscross 5y ago
> we should try to fix the societal problems generating the poor outcome What would this look like policywise?
- dantheman 5y ago
  Stop tariffs on sugar and end subsidies to corn that lead to high fructose corn syrup.
  - kccqzy 5y ago
    I get that cane sugar is more natural than high fructose corn syrup, and I myself would choose the former over the latter, but aren't these basically the same in terms of causing obesity?
    - jjj123 5y ago
      I’m talking out of my ass here but wouldn’t raising the price floor of sugar lower the incentive for companies to make high sugar foods?
- rjbwork 5y ago
  Walkable and bikable cities and suburbs. Increased transit. Reduced working hours so that people don't feel the need to choose between health and survival and stress. Getting the garbage out of our supermarkets. Not subsidizing massive amounts of corn syrup and sugar. I really could go on.
  - boomskats 5y ago
    But who is going to lobby for any of those things?
    - frabjoused 5y ago
      20 years ago, who is going to lobby for electrical cars or solar power? They aren't financially profitable.
      - kiba 5y ago
        It's far easier to make technological progress than it is to fight in politics.
    - lolpython 5y ago
      We already are. At the national level, there is a High Speed Rail lobby group http://www.ushsr.com/ http://www.ushsr.com/ At the local level, it is up to you. In my city of Pittsburgh, we are removing parking and expanding transit access and bike lane coverage. But there is still a lot to be done, so I am advocating for change by participating in groups and contacting my city councilman.
  - baggy_trough 5y ago
    The so-called "garbage" in our supermarkets is there because people want to buy it. What gives somebody else the right to say that they should not do so?
  - aww_dang 5y ago
    If you're a cycling enthusiast you'll always find a way. As you develop as a cyclist areas which once intimidated you may feel safer. It is like any other skill in that way. I know many would prefer bike lanes, but bicycle infrastructure isn't always safer for cyclists. Often city planners have no concept of what actually goes on, so even when token lines are painted on the street - it does nothing to increase cycling. It may be best to put aside the issues of investment and which top-down solution is the best. There may be a time and place for that, but in the near term individuals with an interest can develop their skills incrementally. Disclaimer: I am a self admitted cycling extremist
- sam0x17 5y ago
  Legislation banning overly processed foods. Better school lunches. etc. Pick a "first world" country with much better BMI. Copy all of their regulations surrounding food and agriculture.
  - dragontamer 5y ago
    Every "processed food" definition is incredibly arbitrary, and not necessarily correlated to health. What about rolled oats or steel cut oats? They're clearly "processed", oats don't look like that when they come off the plant. Potato chips + fries are just cut potatoes dropping into a vat of oil. Oil itself isn't very much processed either. But we all know that potato chips / fries are unhealthy and shouldn't be eaten all the time. Cheese or butter require incredible amounts of processing to get done. But when properly portioned, they are part of a healthy diet (more so than potato chips anyway). -------- Is honey any healthier than sugar? Is juice healthier than soda? From an obesity perspective, not really. You really want to be cutting back on these empty calories. (Sure, juice is __slightly__ better than soda cause juice has vitamins in it. But... its actually not that good for you)
    - CabSauce 5y ago
      Do you really think we can't come up with some definitions that at least push in the right direction? They don't have to be perfect, but just start somewhere and keep evolving in the right direction. Let's not pretend we have to get it perfect before we try anything.
      - dragontamer 5y ago
        Instead of banning (or discouraging) "processed foods", lets start with banning/discouraging "unhealthy foods". Because "unhealthy" is a better starting point than the arbitrary metric "processed". ------- You're going to do more for your health by cutting back on your rice portions, rather than worrying about what is or isn't processed. (And rice is barely "processed" at all... but its incredibly calorie dense with high glycemic index). Switching out bread portions (since bread is highly processed) for rice portions won't do you jack diddly squat. Both are high calorie / high glycemic index foods.
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- CabSauce 5y ago
  At a minimum, make it more costly to eat unhealthy foods by taxing added sugar and subsidizing healthy foods.
  - maerF0x0 5y ago
    IMO we dont need more late (consumer) applied taxes, first we need to remove the negative taxes (subsidies) from the input.
    - CabSauce 5y ago
      That's a great start. However, any tax/subsidy filters down to the consumer in a roughly efficient market.
      - maerF0x0 5y ago
        Sure, but a subsidy + tax in the chain is itself inefficient way to structure a market (ie takes a lot of software and accountants) . Better to just not do it at all.
  - epi789 5y ago
    Taxes won’t work. People want autonomy. If you provide healthy meats and unprocessed foods, people will choose it. It’s a problem of access and convenience not necessarily choice.
    - CabSauce 5y ago
      That's just clearly not true with current incentives. Healthy options are more available now than any time in the past.
- maerF0x0 5y ago
  Michael Pollan (in his cooked netflix show) has pointed out that the cost of "junk food" has been heavily subsidized (eg corn subsidy), but fresh produce has not. Subsequently the consumer price of each has fallen, or risen a lot, respectively. One policy choice (amongst many required) could be to stop subsidizing the inputs to junk food. Another policy I've heard talked about by Joel Salatin is that a lot of low processed foods are getting crushed by regulation because the cost/barriers are very high and demand scale/volume. For example poultry processing is only feasible on a massive scale because of regulation policies like (paraphrased) "there must be a dedicated washroom onsite for the inspector to use". That makes no sense if you only process 10000 birds a year (something like $100k of gross market value).
  - baggy_trough 5y ago
    That's precisely the point of much of this legislation as it favors the big players who are in bed with the regulators.
- woodruffw 5y ago
  We can probably look at large cities for appropriate policy here: increased investment in pedestrian and cycling infrastructure, localized access to fresh groceries (eliminating food deserts), and investment in public parks and other facilities. NYC's obesity rate is half of the nation's; we could still do better, but it's a starting point.
  - JumpCrisscross 5y ago
    > NYC's obesity rate is half of the nation's This is a function of density. We walk more. Look at the boroughs that drive and they're closer to the national average. Replicating this in e.g. San Francisco would require overcoming the anti-development NIMBYs. That's a hard problem.
xyzzy21 5y ago
Very true. When it's easier to drive across the street or down the block than walk, you will be less healthy. Part of what I loved about living in Asia (Taipei, Tokyo, et al.) was that public transit required walking to, between and from stations/stops. It's not much but it's just enough.
echelon 5y ago
People love to rail on suburbs, but I'd be willing to bet that sugar is the real problem. Sugar is in everything. Snacks, restaurant food, drinks, sauces. It puts the metabolism into a bad state and desensitizes the body to its deleterious effects. Before you know it you're overweight, mentally foggy, and pre-diabetic. Not a good place to start working out or going for outdoor activities. People exercise and walk more when they have energy to do so. Sugar saps that away. Look at people in other "confined" spaces: submarines, ships, the space station. These people are not overweight for lack of walking. It's diet. America is pumped full of sugar. edit to respond to comments (since I'm flagged / rate limited) : Someone with a healthy body and mind won't "sit on their ass 23 hours a day". They won't consume too many calories, either. Sugar pushes the body into more lethargy and higher sugar consumption.
- op00to 5y ago
  Sugar does not “sap your energy away”. Sitting on your ass 23 hours a day does.
  - maerF0x0 5y ago
    Caloric balance is the key. You can lose a lot of weight sitting on your ass, but also not eating all that much (ie calorie deficit)
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- maerF0x0 5y ago
  I follow Layne Norton on youtube, and he has a lot of great videos where he talks about how sugar(nor fat, insulin) are the real issue at hand. He does a great job of reading, and synthesizing lots of research into recommendations. Both for himself as a competition bodybuilder and power lifter, but also as a PhD. Ok, appeal to expertise aside. And yes, many will find him obnoxious in his demeanor, but that's not a rebuttal of his point. His point basically is that Sugar is not in any way except for how it contributes to excess caloric intake. The key here is that sugar contains calories and can attribute to hyper-caloric state. But you can also eat lots of sugar and be in a hypo-caloric state. Therefore sugar has nothing to do with it. Total consumption is everything here (and body fat percent). Have a watch of these videos: https://www.youtube.com/watch?v=9JrT84PeTgw https://www.youtube.com/watch?v=9JrT84PeTgw https://www.youtube.com/watch?v=-eq8VObUFsk https://www.youtube.com/watch?v=-eq8VObUFsk https://www.youtube.com/watch?v=G3WN4zrEENY https://www.youtube.com/watch?v=G3WN4zrEENY
canjobear 5y ago
City design and the food industry haven't changed substantially in the last 40 years. If anything, there has been increasing emphasis on walkability in communities and health in foods. And yet the obesity rate was 15% in 1980 and 42% now.
- snakeboy 5y ago
  Isn't that expected? People born since 1980 grew up with those sticky habits/culture around food and exercise, and are a growing proportion of the population.
paulddraper 5y ago
The problem with "policy solutions" is that they don't account for individual preferences. Do people want walkable cities? Or do they want single-family dwellings and yards? Do people want to be healthy? Or do they want sugary foods and television programs? Fortunately, the U.S. has plenty of each, to accommodate multiple preferences. Life is trade-offs. It's the conceit of policy makers to force their trade-off preferences on people.
- woodruffw 5y ago
  > Fortunately, the U.S. has plenty of each, to accommodate multiple preferences. As of 2010, close to 24 million Americans lived in a "food desert"[1], i.e. an area without adequate access to healthy eating choices. These areas are disproportionately lower SES areas, and the people in them don't get to have a "preference"; the decision is being made for them. Edit: Here's a paper explaining the correlation and absence of choice in detail[2]. [1]: https://en.wikipedia.org/wiki/Food_desert https://en.wikipedia.org/wiki/Food_desert [2]: https://academic.oup.com/nutritionreviews/article/66/4/216/1864784 https://academic.oup.com/nutritionreviews/article/66/4/216/1...
  - paulddraper 5y ago
    My point was the the U.S. has plenty of each place. So, yeah, that's exactly my point.
    - woodruffw 5y ago
      Your point is that food deserts are evidence of preference? That doesn’t make a lot of sense: privation is defined by the absence of actual choice.
- CabSauce 5y ago
  An alternative approach is to encourage people to make more effective decisions by actually including the negative impacts of their decisions as actual, dollar costs. If we included the higher healthcare costs of obesity into the cost of soda, it might not be as enticing. This isn't forcing people to make a decision, it's including all of the costs in the dollar value of the product on the shelf.
mc32 5y ago
City design hasn’t helped; however, even in places where walkability and public transit are good, Mexico City, Paris, China, etc., people are becoming obese. Something else is a major contributor to this.
kiba 5y ago
Yes, exercise is good for you, and should be taken, but diet seems to be the most important factor. Research had came out indicating that exercise doesn't really do much good in losing weight. Might help in maintaining weight.
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- ptmcc 5y ago
  Indeed it's a heck of a lot easier to not eat 500 calories than to burn off 500 calories. Running a 5k doesn't even burn 500 calories for most people, but you can eat that much in snacks without a second thought. To really make a difference in weight the much more important side of the equation is intake.
  - kiba 5y ago
    It get worse. Apparently, your body adjust its basal metabolism over the long term in response to daily physical activity.
  - osigurdson 5y ago
    While I am not completely convinced that it works to greatly improve fitness, I can attest that the low heart rate running approach (google Maffetone:180 - age) approach does not seem to increase appetite at all.
- ultrarunner 5y ago
  I realize that this discussion is focused on obesity, but the above response comes out every time weight loss is discussed. It may well be accurate in many cases, but I don't think it encompasses the full picture of health. For example, smoking has shown to aid weight loss, but the outcome of taking up smoking is a skinnier person with a new set of comorbidities. If the desired outcome is an improved quality of life, exercise has a plethora of mental-health benefits [0], cardiovascular and energy improvements[1], and has negative correlations with some of the risk-factors of obesity, like type 2 diabetes, high blood pressure, and some cancers [1][2]. I would hate for someone to read the common response and conclude that since obesity is causing their problems and weight loss seems more affected by diet changes, that exercise doesn't matter and can be safely skipped. To have a different life a lifestyle change is needed. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470658/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470658/ [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6172294/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6172294/ [2] https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20048389 https://www.mayoclinic.org/healthy-lifestyle/fitness/in-dept...
hncurious 5y ago
Unpopular opinion: It's both a personal and societal failing, but personal choice is dominant. You can choose to eat rice and beans and drink water. You don't have to eat hamburgers and fries and drink sugar.
- minikites 5y ago
  Not everyone has the time to prepare healthy meals, that's why convenience foods are so popular in our overworked society. If the average person spent less time working, they would have more time to shop for and prepare healthy meals.
  - hncurious 5y ago
    The average person in this country has time to binge watch Netflix and social media. Have you seen the stats? We do have the time. Of course there are exceptions, but we're a long long way from only having the exceptions left.
    - kiba 5y ago
      We may have the time, but we may not have the skills. It's also work to cook food. People also don't know tricks like meal preps, sous vide, and slow cooking.
- nradov 5y ago
  Hamburgers aren't necessarily more obesogenic than rice and beans, depending on the specific type of bun and condiments. Rice has a fairly high glycemic index. Nothing wrong with eating some rice in moderation, but getting the majority of your calories from rice isn't healthy. https://www.health.harvard.edu/healthbeat/a-good-guide-to-good-carbs-the-glycemic-index https://www.health.harvard.edu/healthbeat/a-good-guide-to-go...
  - throw8383833jj 5y ago
    They are, if they're designed to be addictively delicious. McDonalds and their ilk, have created taste formulas that are nearly irresistable. I've seen people from foreign countries come to america who've never tasted anything other than their local cuisines who can't imagine eating anything else. but the second they sink their teeth into a McDon hamburger, they are hooked. MSG has been shown as a super reliable way to make mice obese: there's even a scientific procedure named after it: "MSG induced Obestity". It's a standard procedure used as a precurser to obesity experiments on rats. If it's that reliable on rats, just imagine what it would do to humans.
epi789 5y ago
That’s because it’s profitable and it’s very difficult to make systemic changes. Here’s a few points: - In the documentary Fed Up, it showed how Michelle Obama had to back down to the big food companies over her push for healthier food. - I worked with bariatric surgeons and some incredibly cited papers stating that people can’t lose weight by diet and exercise alone. The surgeons I knew were incredibly narrow-minded and uninterested in any counter arguments. - Sleeve gastrectomies are the most effective technology to fight obesity. If someone can’t change on their own in 10 years, then it is a good option. It removes 90% of the stomach including the hunger hormone ghrelin. - The surgeon I worked with had a sleeve procedure, stretched his stomach out, and had a 2nd sleeve. - Long term, the food environment has to change. Living expenses are high, work demands are high, people are stressed and all the easy options are terrible for you. - We should distribute good meats, foods, vegetables and essentials in an entirely new way. - Our business leaders like Buffett and Gates need to realize the absurdity of respectively owning Coca Cola and selling potatoes to the fast food industry. Buffet also owns DaVita, a dialysis company. Gates promotes global health but earns money from french fries being sold at McDonalds.
- pjscott 5y ago
  > Living expenses are high, work demands are high, people are stressed and all the easy options are terrible for you. It's not obvious, but there are some ways to trade relatively small amounts of inconvenience for food that's healthier and often cheaper. Some people will cook enough food on a weekend to last the rest of a week with refrigeration, optionally dividing it up into single-serving containers. Since a lot of recipes scale up well, this ends up taking much less cooking time than doing one meal at a time, and the labor is shifted to weekends when you might have more energy. A quality-of-life variation on this idea is to do ingredient preparation for a week on the weekend -- chop the vegetables, measure things out, etc. -- and cook meals for four days, then do a second (much quicker) batch of cooking mid-week so the food doesn't spend too long in the fridge. Googling for "once a week meal prep" will turn up a lot more information on this. The big problem with the approach above, of course, is the monotony: having only a handful of meal choices each week can get old after a few days. For people who are willing to cook more often but would still like to economize on time, this guide from last year on quarantine meal-planning for people who normally don't make most of their food at home is very good: https://www.seriouseats.com/our-tips-for-meal-planning-during-self-isolation https://www.seriouseats.com/our-tips-for-meal-planning-durin... In particular, the big thing to take from it is the idea of making larger batches of meal components that you can quickly put together in various combinations with different flavors, which lets you save on cooking time (and shift it to when it's more convenient) while also giving more variety in your diet.
nradov 5y ago
My pet hypothesis is that widespread use of endocrine disruptor chemicals such as phthalates (plastic softeners) is one of several key causes for increasing obesity. There isn't real proof of that yet. But exposure is correlated with lower testosterone levels, and we know that low T can cause growth of adipose tissue. https://www.endocrine.org/news-and-advocacy/news-room/2014/reduced-testosterone-tied-to-endocrine-disrupting-chemical-exposure https://www.endocrine.org/news-and-advocacy/news-room/2014/r...
- maxerickson 5y ago
  Being sedentary is also associated with lower testosterone. People are less active in their work and lives, and not just a little bit.
torginus 5y ago
There have been many suggestions in this thread about the root cause of obesity. While I'm sure these things do contribute to the issue, they are not the main cause - the main cause is that being fat is socially acceptable. I don't believe that if the average person placed great importance on being healthy - as great as making more money, getting a better job etc., they would be unable to afford the extra cost of healthy food, fit a couple of hours of exercise per week into their routines, or do whatever it takes to maintain a healthy physique.
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- gibagger 5y ago
  I don't think healthy food has to be expensive. It can be if one decides to go the "superfood" route, also if one decides to eat beef / fish with every other meal. The fact is that multigrain bread, oats, beans, lentils and peanuts are all cheap, filling good sources of fiber and protein. Large animal protein portions are rarely truly needed. Combine that with some vegetables, a bit of oil, some spices, a modest portion of pork/chicken protein, and you end up with an inexpensive healthy meal. I understand that eating well has other costs (namely, the time and effort it takes to make it and clean up afterwards). For people who value their health, this cost is usually acceptable.
  - feudalism 5y ago
    There's even a helpful subreddit r/EatCheapAndHealthy
- kiba 5y ago
  Seems to be a form of victim blaming. If people tried to follow normal dieting advice, and they failed, do we keep telling them to try harder? I am speaking as someone who had lost a lot of weight and achieved near normal BMI and had prioritized health. I found intermittent fasting to be much easier and less willpower taxing than counting calories, which was way too much work. People do want to be healthier and a lot of people really tried hard. Problem is, in other societies, it's effortless.
sershe 5y ago
Well if it's pet theory time, mine is that it's all the sauces, dressings, ketchups, breadcrumbs, and other additions, and indirectly salt and spices. My exhibit #1 are 800-calories salads at Cheesecake Factory. My exhibit #2 is an American dude in Munich telling me the (wonderful, tasty) local pork is "flavorless" and they needs to add some crap to it, or at least give him some ketchup. You can eat anything - vegetables, meat, fish, potatoes, pasta, bread - and be pretty thin. If you add 500 calories of dressing to a salad, then no matter what you eat, you are doomed... also, that and spices would bomb out your taste buds, so you wouldn't even be able to enjoy "purer" food anymore.

JumpCrisscross 5y ago

> we should try to fix the societal problems generating the poor outcome What would this look like policywise?

dantheman 5y ago
Stop tariffs on sugar and end subsidies to corn that lead to high fructose corn syrup.
- kccqzy 5y ago
  I get that cane sugar is more natural than high fructose corn syrup, and I myself would choose the former over the latter, but aren't these basically the same in terms of causing obesity?
  - jjj123 5y ago
    I’m talking out of my ass here but wouldn’t raising the price floor of sugar lower the incentive for companies to make high sugar foods?
rjbwork 5y ago
Walkable and bikable cities and suburbs. Increased transit. Reduced working hours so that people don't feel the need to choose between health and survival and stress. Getting the garbage out of our supermarkets. Not subsidizing massive amounts of corn syrup and sugar. I really could go on.
- boomskats 5y ago
  But who is going to lobby for any of those things?
  - frabjoused 5y ago
    20 years ago, who is going to lobby for electrical cars or solar power? They aren't financially profitable.
    - kiba 5y ago
      It's far easier to make technological progress than it is to fight in politics.
  - lolpython 5y ago
    We already are. At the national level, there is a High Speed Rail lobby group http://www.ushsr.com/ http://www.ushsr.com/ At the local level, it is up to you. In my city of Pittsburgh, we are removing parking and expanding transit access and bike lane coverage. But there is still a lot to be done, so I am advocating for change by participating in groups and contacting my city councilman.
- baggy_trough 5y ago
  The so-called "garbage" in our supermarkets is there because people want to buy it. What gives somebody else the right to say that they should not do so?
- aww_dang 5y ago
  If you're a cycling enthusiast you'll always find a way. As you develop as a cyclist areas which once intimidated you may feel safer. It is like any other skill in that way. I know many would prefer bike lanes, but bicycle infrastructure isn't always safer for cyclists. Often city planners have no concept of what actually goes on, so even when token lines are painted on the street - it does nothing to increase cycling. It may be best to put aside the issues of investment and which top-down solution is the best. There may be a time and place for that, but in the near term individuals with an interest can develop their skills incrementally. Disclaimer: I am a self admitted cycling extremist
sam0x17 5y ago
Legislation banning overly processed foods. Better school lunches. etc. Pick a "first world" country with much better BMI. Copy all of their regulations surrounding food and agriculture.
- dragontamer 5y ago
  Every "processed food" definition is incredibly arbitrary, and not necessarily correlated to health. What about rolled oats or steel cut oats? They're clearly "processed", oats don't look like that when they come off the plant. Potato chips + fries are just cut potatoes dropping into a vat of oil. Oil itself isn't very much processed either. But we all know that potato chips / fries are unhealthy and shouldn't be eaten all the time. Cheese or butter require incredible amounts of processing to get done. But when properly portioned, they are part of a healthy diet (more so than potato chips anyway). -------- Is honey any healthier than sugar? Is juice healthier than soda? From an obesity perspective, not really. You really want to be cutting back on these empty calories. (Sure, juice is __slightly__ better than soda cause juice has vitamins in it. But... its actually not that good for you)
  - CabSauce 5y ago
    Do you really think we can't come up with some definitions that at least push in the right direction? They don't have to be perfect, but just start somewhere and keep evolving in the right direction. Let's not pretend we have to get it perfect before we try anything.
    - dragontamer 5y ago
      Instead of banning (or discouraging) "processed foods", lets start with banning/discouraging "unhealthy foods". Because "unhealthy" is a better starting point than the arbitrary metric "processed". ------- You're going to do more for your health by cutting back on your rice portions, rather than worrying about what is or isn't processed. (And rice is barely "processed" at all... but its incredibly calorie dense with high glycemic index). Switching out bread portions (since bread is highly processed) for rice portions won't do you jack diddly squat. Both are high calorie / high glycemic index foods.
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CabSauce 5y ago
At a minimum, make it more costly to eat unhealthy foods by taxing added sugar and subsidizing healthy foods.
- maerF0x0 5y ago
  IMO we dont need more late (consumer) applied taxes, first we need to remove the negative taxes (subsidies) from the input.
  - CabSauce 5y ago
    That's a great start. However, any tax/subsidy filters down to the consumer in a roughly efficient market.
    - maerF0x0 5y ago
      Sure, but a subsidy + tax in the chain is itself inefficient way to structure a market (ie takes a lot of software and accountants) . Better to just not do it at all.
- epi789 5y ago
  Taxes won’t work. People want autonomy. If you provide healthy meats and unprocessed foods, people will choose it. It’s a problem of access and convenience not necessarily choice.
  - CabSauce 5y ago
    That's just clearly not true with current incentives. Healthy options are more available now than any time in the past.
maerF0x0 5y ago
Michael Pollan (in his cooked netflix show) has pointed out that the cost of "junk food" has been heavily subsidized (eg corn subsidy), but fresh produce has not. Subsequently the consumer price of each has fallen, or risen a lot, respectively. One policy choice (amongst many required) could be to stop subsidizing the inputs to junk food. Another policy I've heard talked about by Joel Salatin is that a lot of low processed foods are getting crushed by regulation because the cost/barriers are very high and demand scale/volume. For example poultry processing is only feasible on a massive scale because of regulation policies like (paraphrased) "there must be a dedicated washroom onsite for the inspector to use". That makes no sense if you only process 10000 birds a year (something like $100k of gross market value).
- baggy_trough 5y ago
  That's precisely the point of much of this legislation as it favors the big players who are in bed with the regulators.
woodruffw 5y ago
We can probably look at large cities for appropriate policy here: increased investment in pedestrian and cycling infrastructure, localized access to fresh groceries (eliminating food deserts), and investment in public parks and other facilities. NYC's obesity rate is half of the nation's; we could still do better, but it's a starting point.
- JumpCrisscross 5y ago
  > NYC's obesity rate is half of the nation's This is a function of density. We walk more. Look at the boroughs that drive and they're closer to the national average. Replicating this in e.g. San Francisco would require overcoming the anti-development NIMBYs. That's a hard problem.

xyzzy21 5y ago

Very true. When it's easier to drive across the street or down the block than walk, you will be less healthy. Part of what I loved about living in Asia (Taipei, Tokyo, et al.) was that public transit required walking to, between and from stations/stops. It's not much but it's just enough.

echelon 5y ago

People love to rail on suburbs, but I'd be willing to bet that sugar is the real problem. Sugar is in everything. Snacks, restaurant food, drinks, sauces. It puts the metabolism into a bad state and desensitizes the body to its deleterious effects. Before you know it you're overweight, mentally foggy, and pre-diabetic. Not a good place to start working out or going for outdoor activities. People exercise and walk more when they have energy to do so. Sugar saps that away. Look at people in other "confined" spaces: submarines, ships, the space station. These people are not overweight for lack of walking. It's diet. America is pumped full of sugar. edit to respond to comments (since I'm flagged / rate limited) : Someone with a healthy body and mind won't "sit on their ass 23 hours a day". They won't consume too many calories, either. Sugar pushes the body into more lethargy and higher sugar consumption.

op00to 5y ago
Sugar does not “sap your energy away”. Sitting on your ass 23 hours a day does.
- maerF0x0 5y ago
  Caloric balance is the key. You can lose a lot of weight sitting on your ass, but also not eating all that much (ie calorie deficit)
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maerF0x0 5y ago
I follow Layne Norton on youtube, and he has a lot of great videos where he talks about how sugar(nor fat, insulin) are the real issue at hand. He does a great job of reading, and synthesizing lots of research into recommendations. Both for himself as a competition bodybuilder and power lifter, but also as a PhD. Ok, appeal to expertise aside. And yes, many will find him obnoxious in his demeanor, but that's not a rebuttal of his point. His point basically is that Sugar is not in any way except for how it contributes to excess caloric intake. The key here is that sugar contains calories and can attribute to hyper-caloric state. But you can also eat lots of sugar and be in a hypo-caloric state. Therefore sugar has nothing to do with it. Total consumption is everything here (and body fat percent). Have a watch of these videos: https://www.youtube.com/watch?v=9JrT84PeTgw https://www.youtube.com/watch?v=9JrT84PeTgw https://www.youtube.com/watch?v=-eq8VObUFsk https://www.youtube.com/watch?v=-eq8VObUFsk https://www.youtube.com/watch?v=G3WN4zrEENY https://www.youtube.com/watch?v=G3WN4zrEENY

canjobear 5y ago

City design and the food industry haven't changed substantially in the last 40 years. If anything, there has been increasing emphasis on walkability in communities and health in foods. And yet the obesity rate was 15% in 1980 and 42% now.

snakeboy 5y ago
Isn't that expected? People born since 1980 grew up with those sticky habits/culture around food and exercise, and are a growing proportion of the population.

paulddraper 5y ago

The problem with "policy solutions" is that they don't account for individual preferences. Do people want walkable cities? Or do they want single-family dwellings and yards? Do people want to be healthy? Or do they want sugary foods and television programs? Fortunately, the U.S. has plenty of each, to accommodate multiple preferences. Life is trade-offs. It's the conceit of policy makers to force their trade-off preferences on people.

woodruffw 5y ago
> Fortunately, the U.S. has plenty of each, to accommodate multiple preferences. As of 2010, close to 24 million Americans lived in a "food desert"[1], i.e. an area without adequate access to healthy eating choices. These areas are disproportionately lower SES areas, and the people in them don't get to have a "preference"; the decision is being made for them. Edit: Here's a paper explaining the correlation and absence of choice in detail[2]. [1]: https://en.wikipedia.org/wiki/Food_desert https://en.wikipedia.org/wiki/Food_desert [2]: https://academic.oup.com/nutritionreviews/article/66/4/216/1864784 https://academic.oup.com/nutritionreviews/article/66/4/216/1...
- paulddraper 5y ago
  My point was the the U.S. has plenty of each place. So, yeah, that's exactly my point.
  - woodruffw 5y ago
    Your point is that food deserts are evidence of preference? That doesn’t make a lot of sense: privation is defined by the absence of actual choice.
CabSauce 5y ago
An alternative approach is to encourage people to make more effective decisions by actually including the negative impacts of their decisions as actual, dollar costs. If we included the higher healthcare costs of obesity into the cost of soda, it might not be as enticing. This isn't forcing people to make a decision, it's including all of the costs in the dollar value of the product on the shelf.

mc32 5y ago

City design hasn’t helped; however, even in places where walkability and public transit are good, Mexico City, Paris, China, etc., people are becoming obese. Something else is a major contributor to this.

kiba 5y ago

Yes, exercise is good for you, and should be taken, but diet seems to be the most important factor. Research had came out indicating that exercise doesn't really do much good in losing weight. Might help in maintaining weight.

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ptmcc 5y ago
Indeed it's a heck of a lot easier to not eat 500 calories than to burn off 500 calories. Running a 5k doesn't even burn 500 calories for most people, but you can eat that much in snacks without a second thought. To really make a difference in weight the much more important side of the equation is intake.
- kiba 5y ago
  It get worse. Apparently, your body adjust its basal metabolism over the long term in response to daily physical activity.
- osigurdson 5y ago
  While I am not completely convinced that it works to greatly improve fitness, I can attest that the low heart rate running approach (google Maffetone:180 - age) approach does not seem to increase appetite at all.
ultrarunner 5y ago
I realize that this discussion is focused on obesity, but the above response comes out every time weight loss is discussed. It may well be accurate in many cases, but I don't think it encompasses the full picture of health. For example, smoking has shown to aid weight loss, but the outcome of taking up smoking is a skinnier person with a new set of comorbidities. If the desired outcome is an improved quality of life, exercise has a plethora of mental-health benefits [0], cardiovascular and energy improvements[1], and has negative correlations with some of the risk-factors of obesity, like type 2 diabetes, high blood pressure, and some cancers [1][2]. I would hate for someone to read the common response and conclude that since obesity is causing their problems and weight loss seems more affected by diet changes, that exercise doesn't matter and can be safely skipped. To have a different life a lifestyle change is needed. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470658/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470658/ [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6172294/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6172294/ [2] https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20048389 https://www.mayoclinic.org/healthy-lifestyle/fitness/in-dept...

hncurious 5y ago

Unpopular opinion: It's both a personal and societal failing, but personal choice is dominant. You can choose to eat rice and beans and drink water. You don't have to eat hamburgers and fries and drink sugar.

minikites 5y ago
Not everyone has the time to prepare healthy meals, that's why convenience foods are so popular in our overworked society. If the average person spent less time working, they would have more time to shop for and prepare healthy meals.
- hncurious 5y ago
  The average person in this country has time to binge watch Netflix and social media. Have you seen the stats? We do have the time. Of course there are exceptions, but we're a long long way from only having the exceptions left.
  - kiba 5y ago
    We may have the time, but we may not have the skills. It's also work to cook food. People also don't know tricks like meal preps, sous vide, and slow cooking.
nradov 5y ago
Hamburgers aren't necessarily more obesogenic than rice and beans, depending on the specific type of bun and condiments. Rice has a fairly high glycemic index. Nothing wrong with eating some rice in moderation, but getting the majority of your calories from rice isn't healthy. https://www.health.harvard.edu/healthbeat/a-good-guide-to-good-carbs-the-glycemic-index https://www.health.harvard.edu/healthbeat/a-good-guide-to-go...
- throw8383833jj 5y ago
  They are, if they're designed to be addictively delicious. McDonalds and their ilk, have created taste formulas that are nearly irresistable. I've seen people from foreign countries come to america who've never tasted anything other than their local cuisines who can't imagine eating anything else. but the second they sink their teeth into a McDon hamburger, they are hooked. MSG has been shown as a super reliable way to make mice obese: there's even a scientific procedure named after it: "MSG induced Obestity". It's a standard procedure used as a precurser to obesity experiments on rats. If it's that reliable on rats, just imagine what it would do to humans.

epi789 5y ago

That’s because it’s profitable and it’s very difficult to make systemic changes. Here’s a few points: - In the documentary Fed Up, it showed how Michelle Obama had to back down to the big food companies over her push for healthier food. - I worked with bariatric surgeons and some incredibly cited papers stating that people can’t lose weight by diet and exercise alone. The surgeons I knew were incredibly narrow-minded and uninterested in any counter arguments. - Sleeve gastrectomies are the most effective technology to fight obesity. If someone can’t change on their own in 10 years, then it is a good option. It removes 90% of the stomach including the hunger hormone ghrelin. - The surgeon I worked with had a sleeve procedure, stretched his stomach out, and had a 2nd sleeve. - Long term, the food environment has to change. Living expenses are high, work demands are high, people are stressed and all the easy options are terrible for you. - We should distribute good meats, foods, vegetables and essentials in an entirely new way. - Our business leaders like Buffett and Gates need to realize the absurdity of respectively owning Coca Cola and selling potatoes to the fast food industry. Buffet also owns DaVita, a dialysis company. Gates promotes global health but earns money from french fries being sold at McDonalds.

pjscott 5y ago
> Living expenses are high, work demands are high, people are stressed and all the easy options are terrible for you. It's not obvious, but there are some ways to trade relatively small amounts of inconvenience for food that's healthier and often cheaper. Some people will cook enough food on a weekend to last the rest of a week with refrigeration, optionally dividing it up into single-serving containers. Since a lot of recipes scale up well, this ends up taking much less cooking time than doing one meal at a time, and the labor is shifted to weekends when you might have more energy. A quality-of-life variation on this idea is to do ingredient preparation for a week on the weekend -- chop the vegetables, measure things out, etc. -- and cook meals for four days, then do a second (much quicker) batch of cooking mid-week so the food doesn't spend too long in the fridge. Googling for "once a week meal prep" will turn up a lot more information on this. The big problem with the approach above, of course, is the monotony: having only a handful of meal choices each week can get old after a few days. For people who are willing to cook more often but would still like to economize on time, this guide from last year on quarantine meal-planning for people who normally don't make most of their food at home is very good: https://www.seriouseats.com/our-tips-for-meal-planning-during-self-isolation https://www.seriouseats.com/our-tips-for-meal-planning-durin... In particular, the big thing to take from it is the idea of making larger batches of meal components that you can quickly put together in various combinations with different flavors, which lets you save on cooking time (and shift it to when it's more convenient) while also giving more variety in your diet.

nradov 5y ago

My pet hypothesis is that widespread use of endocrine disruptor chemicals such as phthalates (plastic softeners) is one of several key causes for increasing obesity. There isn't real proof of that yet. But exposure is correlated with lower testosterone levels, and we know that low T can cause growth of adipose tissue. https://www.endocrine.org/news-and-advocacy/news-room/2014/reduced-testosterone-tied-to-endocrine-disrupting-chemical-exposure https://www.endocrine.org/news-and-advocacy/news-room/2014/r...

maxerickson 5y ago
Being sedentary is also associated with lower testosterone. People are less active in their work and lives, and not just a little bit.

torginus 5y ago

There have been many suggestions in this thread about the root cause of obesity. While I'm sure these things do contribute to the issue, they are not the main cause - the main cause is that being fat is socially acceptable. I don't believe that if the average person placed great importance on being healthy - as great as making more money, getting a better job etc., they would be unable to afford the extra cost of healthy food, fit a couple of hours of exercise per week into their routines, or do whatever it takes to maintain a healthy physique.

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gibagger 5y ago
I don't think healthy food has to be expensive. It can be if one decides to go the "superfood" route, also if one decides to eat beef / fish with every other meal. The fact is that multigrain bread, oats, beans, lentils and peanuts are all cheap, filling good sources of fiber and protein. Large animal protein portions are rarely truly needed. Combine that with some vegetables, a bit of oil, some spices, a modest portion of pork/chicken protein, and you end up with an inexpensive healthy meal. I understand that eating well has other costs (namely, the time and effort it takes to make it and clean up afterwards). For people who value their health, this cost is usually acceptable.
- feudalism 5y ago
  There's even a helpful subreddit r/EatCheapAndHealthy
kiba 5y ago
Seems to be a form of victim blaming. If people tried to follow normal dieting advice, and they failed, do we keep telling them to try harder? I am speaking as someone who had lost a lot of weight and achieved near normal BMI and had prioritized health. I found intermittent fasting to be much easier and less willpower taxing than counting calories, which was way too much work. People do want to be healthier and a lot of people really tried hard. Problem is, in other societies, it's effortless.

sershe 5y ago

Well if it's pet theory time, mine is that it's all the sauces, dressings, ketchups, breadcrumbs, and other additions, and indirectly salt and spices. My exhibit #1 are 800-calories salads at Cheesecake Factory. My exhibit #2 is an American dude in Munich telling me the (wonderful, tasty) local pork is "flavorless" and they needs to add some crap to it, or at least give him some ketchup. You can eat anything - vegetables, meat, fish, potatoes, pasta, bread - and be pretty thin. If you add 500 calories of dressing to a salad, then no matter what you eat, you are doomed... also, that and spices would bomb out your taste buds, so you wouldn't even be able to enjoy "purer" food anymore.